323 75TH ST SE BLDG A 2023-07-31

Intake &Approval Sheet 410 (FOR PERMIT STAFF ONLY) • PERMIT# 22pG-o3 U MiTrAVICrAttijaI O Ir Intake OK by: Date: Intake OK by: Assign To: Date: Intake Comments: Intake Comments: ❑ Route to Commercial Building ❑Attach to Project No. ❑ Route to Residential Building ❑ Route to Historic Reviewer ❑ Make this a"W"Permit 0 OK to Route to Other Departments Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer Garage/Accessory Struct.Size Zone Number of Stories Overlay/Agreement Basement ❑No ❑Yes, Fin/Unfin Nonresidential Use Type of Construction Residential Use Occupancy Group /L—/ Proposed No.of Dwelling Units: Occupancy Load Total No.of Dwelling Units: Fire Sprinklers: CI Update Existing ❑New System ElNot Req'd Planning/Landscape Inspection Required before Final? ❑Yes,No Reason Sprinklers Required: "In Lieu"Fee:Type: Amount$ Fire Alarm: CI Update Existing CI New System Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes No Additional Notes: up/mot/0—-p_-&_ \S VALUATION CALCULATION: Total $ I V i .an ,b-nS (p€J\ or (y1 �\j' IT- " Approved By: Date: 22_ Crw *R\ice 7 , Intake OK by: Date: Additional Notes: Intake Comments: I PW Worksheet Needed if. Y Amoz_z_44 47r I❑Sys Dev Eval OTraffic Mit Eval ❑Site Work or Drainage Proposed Approved B�f t `J,...,4,1; Date:D7,',50 � I❑Backflaw Prevention for high hazard: i(dental,medical,animals,mortuary,hospital, supportive housing) iTlhl ❑Route this folder for PW Review at end --- PW Review Worksheet Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review (Green Folder) ❑Fire Sprinklers OFire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously ❑Deferred Additional Notes: ❑ This Permit is Approved by Public Works ❑ See PW Review Worksheet and associated attached items Fire Dept. Fees: ❑ A Separate PW Permit is Required(Permit#: PW ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder ❑ Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder (join with this folder for permit issuance) ❑ Review/Inspection Scope-ADD FIRE FEE ❑ Will be issued separately (Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: ❑ Public Works has no scope--- PW Not Required Additional Notes: L1PL Additional Notes: Approved By: Date: Approved By: Date: